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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005207
Report Date: 03/20/2025
Date Signed: 03/20/2025 10:05:21 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/12/2025 and conducted by Evaluator Jerome Haley
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250312162715
FACILITY NAME:HARVEST RETIREMENTFACILITY NUMBER:
306005207
ADMINISTRATOR:GINGER POFACILITY TYPE:
740
ADDRESS:9011 KNOTT AVETELEPHONE:
(714) 821-4130
CITY:BUENA PARKSTATE: CAZIP CODE:
90620
CAPACITY:106CENSUS: 76DATE:
03/20/2025
UNANNOUNCEDTIME BEGAN:
09:00 PM
MET WITH:Rose EnriquezTIME COMPLETED:
09:50 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not treat residents with respect.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Regarding the complaint allegation: Staff did not treat residents with respect.

During the investigation 5 of 7 individuals denied the allegation. Staff 6 (S6) strongly denied any staff yelling at residents’ and said that would not happen in front of them. S6 explained if they heard about this happening, they would try to catch the individual in action. Multiple staff members interviewed during the investigation explained that sometimes the caregivers do speak loudly and are encouraged to lower their voice by Staff 1 (S1). According to Staff 3 (S3) sometimes the staff get together and start to talk and sometimes it can get loud. S3 says, S1 will remind them to lower their voice.

Based on the information gathered during the investigation through interviews and document review, the Department is unable to ascertain if the allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, the allegation is deemed Unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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